Elizabeth Uttaro, PharmD, BCEMP
@elizabethuttaro.bsky.social
EM Pharmacist @UR_med | PGY1 & PGY2 EM residency @UR_med | @WSoP_SJFC Alumni | Views are my own
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Flu has become so prevalent in my ICU I just assume every patient has it.
Reminds me of COVID where it was almost always present no matter the admitting diagnosis.
Reminds me of COVID where it was almost always present no matter the admitting diagnosis.
February 17, 2025 at 5:30 PM
Flu has become so prevalent in my ICU I just assume every patient has it.
Reminds me of COVID where it was almost always present no matter the admitting diagnosis.
Reminds me of COVID where it was almost always present no matter the admitting diagnosis.
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Med student: the telemetry monitors are going off on a lot of the patients simultaneously.
Nurse, without skipping a beat: patients are watching football.
Nurse, without skipping a beat: patients are watching football.
January 4, 2025 at 10:43 PM
Med student: the telemetry monitors are going off on a lot of the patients simultaneously.
Nurse, without skipping a beat: patients are watching football.
Nurse, without skipping a beat: patients are watching football.
PSA: please don’t co-sleep with infants
January 5, 2025 at 4:28 PM
PSA: please don’t co-sleep with infants
Reposted by Elizabeth Uttaro, PharmD, BCEMP
#TipsForNewDocs
You too will be a patient one day.
Remember that.
With every word you speak, every look you give and every standard you accept, remember that.
You too will be a patient one day.
Remember that.
With every word you speak, every look you give and every standard you accept, remember that.
December 30, 2024 at 8:23 AM
#TipsForNewDocs
You too will be a patient one day.
Remember that.
With every word you speak, every look you give and every standard you accept, remember that.
You too will be a patient one day.
Remember that.
With every word you speak, every look you give and every standard you accept, remember that.
Reposted by Elizabeth Uttaro, PharmD, BCEMP
🎙️Calling all EM residents!
Submit as idea for our AEMP IGNITE! Resident Pearls
5️⃣ minutes
🏆 Top 3 pearls presented get $100
🚑 open to all pharmacy & medicine residents
Submit here: www.saem.org/meetings-and...!
Submit as idea for our AEMP IGNITE! Resident Pearls
5️⃣ minutes
🏆 Top 3 pearls presented get $100
🚑 open to all pharmacy & medicine residents
Submit here: www.saem.org/meetings-and...!
www.saem.org
December 4, 2024 at 2:31 AM
🎙️Calling all EM residents!
Submit as idea for our AEMP IGNITE! Resident Pearls
5️⃣ minutes
🏆 Top 3 pearls presented get $100
🚑 open to all pharmacy & medicine residents
Submit here: www.saem.org/meetings-and...!
Submit as idea for our AEMP IGNITE! Resident Pearls
5️⃣ minutes
🏆 Top 3 pearls presented get $100
🚑 open to all pharmacy & medicine residents
Submit here: www.saem.org/meetings-and...!
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Today's mantra: I am a stellar pharmacist who continues to be a lifelong learner. I can be simultaneously confident in my practice while humble enough to recognize what I don't know. I deserve to be where I am at, and I will continue to flourish in my position.
December 1, 2024 at 5:04 PM
Today's mantra: I am a stellar pharmacist who continues to be a lifelong learner. I can be simultaneously confident in my practice while humble enough to recognize what I don't know. I deserve to be where I am at, and I will continue to flourish in my position.
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Skytorial: Five pearls on olanzapine 😁
Between agitation and nausea/vomiting, olanzapine has a wide range of use.
Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....
Between agitation and nausea/vomiting, olanzapine has a wide range of use.
Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....
a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom
ALT: a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom
media.tenor.com
November 27, 2024 at 1:17 PM
Skytorial: Five pearls on olanzapine 😁
Between agitation and nausea/vomiting, olanzapine has a wide range of use.
Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....
Between agitation and nausea/vomiting, olanzapine has a wide range of use.
Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Also, your "agitated" patient.
Are they delirious due to infection, or are they in pain and unable to communicate it clearly?
Give simple analgesia if they haven't had any before running to sedatives.
Analgesia FIRST. Always.
#MedSky
Are they delirious due to infection, or are they in pain and unable to communicate it clearly?
Give simple analgesia if they haven't had any before running to sedatives.
Analgesia FIRST. Always.
#MedSky
I feel like I shouldn't have to keep saying this, but it astonishes me that it keeps happening:
If your patient has a very obvious, painful, traumatic injury, give them analgesia. Give them proper doses & give it early.
Yes, even if they aren't screaming.
Don't let people suffer quietly.
#MedSky
If your patient has a very obvious, painful, traumatic injury, give them analgesia. Give them proper doses & give it early.
Yes, even if they aren't screaming.
Don't let people suffer quietly.
#MedSky
November 30, 2024 at 12:07 PM
Also, your "agitated" patient.
Are they delirious due to infection, or are they in pain and unable to communicate it clearly?
Give simple analgesia if they haven't had any before running to sedatives.
Analgesia FIRST. Always.
#MedSky
Are they delirious due to infection, or are they in pain and unable to communicate it clearly?
Give simple analgesia if they haven't had any before running to sedatives.
Analgesia FIRST. Always.
#MedSky
Reposted by Elizabeth Uttaro, PharmD, BCEMP
A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc
At the back of Revision Notes In Intensive Care Medicine there is a list of 59 key papers relating to intensive care medicine published between 1998 and 2015 (the book was published in 2016).
I'd like to keep my revision up to date. Are there any equivalent lists of key papers from 2016 to now?
I'd like to keep my revision up to date. Are there any equivalent lists of key papers from 2016 to now?
November 27, 2024 at 5:16 AM
A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc
Reposted by Elizabeth Uttaro, PharmD, BCEMP
In theory, if there were a class of medications that, with regular use and *especially* at higher doses, caused patients to become horribly ill when the drugs were stopped, we'd be very, very careful about starting them, continuing them, increasing the dose, and stopping them.
November 26, 2024 at 3:24 PM
In theory, if there were a class of medications that, with regular use and *especially* at higher doses, caused patients to become horribly ill when the drugs were stopped, we'd be very, very careful about starting them, continuing them, increasing the dose, and stopping them.
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Hypertensive "urgency" is so very rarely urgent... and treatment has real consequences.
Treat pain, withdrawal, anxiety, and delirium. Stop mIVF. Help patients sleep.
No more IV hydral. #medsky
Treat pain, withdrawal, anxiety, and delirium. Stop mIVF. Help patients sleep.
No more IV hydral. #medsky
I remember as an intern getting calls in the night to give unfamiliar patients intravenous hydralazine for their asymptomatic elevated blood pressure.
Decades later, I'd have thought we know this is harmful and nonsensical, but apparently not entirely. #medsky
jamanetwork.com/journals/jam...
Decades later, I'd have thought we know this is harmful and nonsensical, but apparently not entirely. #medsky
jamanetwork.com/journals/jam...
One-Time and As-Needed Blood Pressure Medication and Adverse Outcomes in VA Hospitals
This cohort study evaluates the risk for acute kidney injury and other adverse effects from as-needed and 1-time blood pressure medications in hospitalized veterans.
jamanetwork.com
November 26, 2024 at 8:03 PM
Hypertensive "urgency" is so very rarely urgent... and treatment has real consequences.
Treat pain, withdrawal, anxiety, and delirium. Stop mIVF. Help patients sleep.
No more IV hydral. #medsky
Treat pain, withdrawal, anxiety, and delirium. Stop mIVF. Help patients sleep.
No more IV hydral. #medsky
Reposted by Elizabeth Uttaro, PharmD, BCEMP
“Oral ibuprofen administered at doses of 400, 600, and 800 mg has similar analgesic efficacy for short-term pain relief in adult patients presenting to the ED with acute pain.”
👉 pubmed.ncbi.nlm.nih.gov/31383385/
#medsky #pharmsky #EMsky #GPsky #nursesky 2/2
👉 pubmed.ncbi.nlm.nih.gov/31383385/
#medsky #pharmsky #EMsky #GPsky #nursesky 2/2
Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial - PubMed
Oral ibuprofen administered at doses of 400, 600, and 800 mg has similar analgesic efficacy for short-term pain relief in adult patients presenting to the ED with acute pain.
pubmed.ncbi.nlm.nih.gov
November 24, 2024 at 1:16 AM
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Less is sometimes more! 💪🏻🔥
NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx
pubmed.ncbi.nlm.nih.gov/27993418/
NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx
pubmed.ncbi.nlm.nih.gov/27993418/
Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial - PubMed
Ketorolac has similar analgesic efficacy at intravenous doses of 10, 15, and 30 mg, showing that intravenous ketorolac administered at the analgesic ceiling dose (10 mg) provided effective pain relief...
pubmed.ncbi.nlm.nih.gov
November 23, 2024 at 1:21 PM
Less is sometimes more! 💪🏻🔥
NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx
pubmed.ncbi.nlm.nih.gov/27993418/
NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx
pubmed.ncbi.nlm.nih.gov/27993418/
Reposted by Elizabeth Uttaro, PharmD, BCEMP
Every single day I’m on service, no matter how tough it is, I remind myself that I get to go home and my babies are there and we all have our health and aren’t staying the night in the hospital.
Perspective is everything.
Perspective is everything.
November 22, 2024 at 10:58 PM
Every single day I’m on service, no matter how tough it is, I remind myself that I get to go home and my babies are there and we all have our health and aren’t staying the night in the hospital.
Perspective is everything.
Perspective is everything.
Reposted by Elizabeth Uttaro, PharmD, BCEMP
the number of times polypharmacy goes unrecognized as a cause of “altered mental status” is astounding
November 23, 2024 at 1:03 AM
the number of times polypharmacy goes unrecognized as a cause of “altered mental status” is astounding
Reposted by Elizabeth Uttaro, PharmD, BCEMP
What an achievement vaccines are. What a monument to our love for each other it is to stare straight into the face of something as horrific and unstoppable as smallpox or measles or polio or cervical cancer and say “You know what, it doesn’t have to be like this.”
HUMANS!
HUMANS!
November 15, 2024 at 1:59 AM
What an achievement vaccines are. What a monument to our love for each other it is to stare straight into the face of something as horrific and unstoppable as smallpox or measles or polio or cervical cancer and say “You know what, it doesn’t have to be like this.”
HUMANS!
HUMANS!
Reposted by Elizabeth Uttaro, PharmD, BCEMP
I will die on this hill:
Every level 1-3 emergency room in the country should have a pharmacist and social worker staffed 24/7. I’ve been in ERs that don’t, and the differences are crystal clear.
Every level 1-3 emergency room in the country should have a pharmacist and social worker staffed 24/7. I’ve been in ERs that don’t, and the differences are crystal clear.
November 11, 2024 at 11:17 PM
I will die on this hill:
Every level 1-3 emergency room in the country should have a pharmacist and social worker staffed 24/7. I’ve been in ERs that don’t, and the differences are crystal clear.
Every level 1-3 emergency room in the country should have a pharmacist and social worker staffed 24/7. I’ve been in ERs that don’t, and the differences are crystal clear.